Predicting proteinuria in hypertensive pregnancies with urinary protein-creatinine or calcium-creatinine ratio.

Objective:Evaluate the value of random urinary protein-creatinine (PrCr) and calcium-creatinine (CaCr) ratios to predict 24-h proteinuria in hypertensive pregnancies.Study Design:Spot urine samples were collected before routine 24-h urine collections from consecutive pregnant women with hypertension (n=83). Reliability of spot urinary PrCr and CaCr to detect significant proteinuria (300 mg/day) using 24-h urine protein as ‘gold-standard’ was assessed by receiver-operating characteristic (ROC) curve.Results:Fifty-one patients (61.4%) had significant proteinuria (45 pre-eclampsia, 5 superimposed pre-eclampsia, 1 renal hypertension). Area under ROC curve to predict proteinuria was 0.82 (95% confidence interval (CI) 0.73 to 0.92, P<0.001) for PrCr and 0.55 (95% CI 0.43 to 0.68, P=0.2) for CaCr. A cutoff value of >0.19 for PrCr best predicted significant proteinuria with sensitivity, specificity, positive and negative predictive values and likelihood ratios (positive and negative), respectively, of 80.4, 68.8, 80.4, 68.8%, 2.57 and 3.51.Conclusion:Spot urinary PrCr predicts total urinary protein excretion in hypertensive pregnancies.Journal of Perinatology (2007) 27, 272–277. doi:10.1038/sj.jp.7211689 [ABSTRACT FROM AUTHOR]